Name: 

Address: 

City: 

State: 

Zip code: 

Day Phone: 

Evening Phone: 

Email Address: 

Preferred Room:  The Josephine Room Victoria Suite The Isabella Room

Check In Date:  January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011

Length of Stay:  (# of nights)

Number of Guests: 

Number of Rooms: 

Special Needs: 

NOTE:  This is NOT a confirmed reservation; only a request.  Someone will contact you to confirm your reservation!